title: Effect of real-time radiation dose feedback on pediatric interventional radiology staff radiation exposure.
abstract: OBJECTIVE
  To measure and compare individual staff radiation dose levels during interventional radiologic (IR) procedures with and without real-time feedback to evaluate whether it has any impact on staff radiation dose.
  
  
  METHODS
  A prospective trial was performed in which individuals filling five different staff roles wore radiation dosimeters during all IR procedures during two phases: a 12-week "closed" phase (measurements recorded but display was off, so no feedback was provided) and a 17-week "open" phase (display was on and provided real-time feedback). Radiation dose rates were recorded and compared by Mann-Whitney U test.
  
  
  RESULTS
  There was no significant difference in median procedure time, fluoroscopy time, or patient dose (dose-area product normalized to fluoroscopy time) between the two phases. Overall, the median staff dose was lower in the open phase (0.56 µSv/min of fluoroscopy time) than in the closed phase (3.01 µSv/min; P < .05). The IR attending physician dose decreased significantly for procedures for which the physicians were close to the patient, but not for ones for which they were far away.
  
  
  CONCLUSIONS
  A radiation dose monitoring system that provides real-time feedback to the interventional staff can significantly reduce radiation exposure to the primary operator, most likely by increasing staff compliance with use of radiation protection equipment and dose reduction techniques.
authors.affiliation: Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229. Electronic address: john.racadio@cchmc.org.
authors.forename: John
authors.initials: J
authors.lastname: Racadio
authors.affiliation: Interventional X-ray Department, Philips Healthcare, Best, The Netherlands.
authors.forename: Rami
authors.initials: R
authors.lastname: Nachabe
authors.affiliation: Interventional X-ray Department, Philips Healthcare, Best, The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Carelsen
authors.affiliation: Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.
authors.forename: Judy
authors.initials: J
authors.lastname: Racadio
authors.affiliation: Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.
authors.forename: Nicole
authors.initials: N
authors.lastname: Hilvert
authors.affiliation: Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.
authors.forename: Neil
authors.initials: N
authors.lastname: Johnson
authors.affiliation: Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Kukreja
authors.affiliation: Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
mesh_terms: D005246:Feedback; D005471:Fluoroscopy; D019983:Guideline Adherence; D006776:Hospitals, Pediatric / Q000592:standards; D006801:Humans; D008505:Medical Staff, Hospital / Q000592:standards; D016273:Occupational Exposure / Q000009:adverse effects / Q000592:standards; D060051:Occupational Injuries / Q000209:etiology / Q000517:prevention & control; D009820:Ohio; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D011834:Radiation Monitoring / Q000379:methods* / Q000592:standards; D015641:Radiography, Interventional / Q000009:adverse effects / Q000592:standards; D013997:Time Factors; D059015:Wireless Technology
keywords: DAP; IQR; IR; dose–area product; interquartile range; interventional radiology